Case and Research Letters
Skin Self-examination Using Smartphone Photography to Improve the Early Diagnosis of Melanoma
Autocontrol fotográfico mediante smartphones para mejorar el diagnóstico precoz del melanoma
S. Vañó-Galván
, J. Paoli, L. Ríos-Buceta, P. Jaén
Corresponding author
Servicio de Dermatología, Hospital Ramón y Cajal, Madrid, Spain
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Vañó-Galván, J. Paoli, L. Ríos-Buceta, P. Jaén" "autores" => array:4 [ 0 => array:4 [ "nombre" => "S." "apellidos" => "Vañó-Galván" "email" => array:1 [ 0 => "sergiovano@yahoo.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Paoli" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Ríos-Buceta" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Jaén" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Hospital Ramón y Cajal, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Autocontrol fotográfico mediante <span class="elsevierStyleItalic">smartphones</span> para mejorar el diagnóstico precoz del melanoma" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1515 "Ancho" => 1000 "Tamanyo" => 141578 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">General design of the smartphone application FotoSkin<span class="elsevierStyleSup">®</span>.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Patient skin self-examination has proven to be very useful in the secondary prevention of melanoma.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–4</span></a> Various studies show that campaigns to raise awareness and to encourage skin self-examination make it possible to diagnose thinner melanomas, thus improving prognosis.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Self-examination can be optimized by taking photographs according to a specific protocol.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> This photographic record facilitates identification of new lesions and reveals significant changes in existing ones. An additional advantage of photographic self-examination systems is that they improve patient adherence and accuracy in self-examination.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Other useful measures in photographic self-examination include comparison of photographs against mole mapping diagrams<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> and visual images of benign and malignant lesions.</p><p id="par0010" class="elsevierStylePara elsevierViewall">At present, photographic self-examination by patients aimed at secondary prevention of melanoma is not a habitual practice,<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> even though it has proven to be effective.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–4</span></a> The reasons for this observation include ignorance of the importance of photographic surveillance, the inconvenience of taking photographs with a camera from which the images then have to be downloaded and stored on a computer, and the lack of adherence to self-examination due to forgetfulness.</p><p id="par0015" class="elsevierStylePara elsevierViewall">We present a technology-based solution to foster patient self-examination, namely, an application for smartphones (FotoSkin®) that enables patients to take regular photographs of their skin according to a specific protocol (mole mapping). These photographs can then be taken to the clinic in order to provide the dermatologist with a more accurate picture of how moles and other types of skin lesions are evolving (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The application also includes 3 sections aimed at improving patients’ knowledge of skin cancer, raising awareness, and, therefore, promoting adherence to self-examination and visits to the dermatologist. The sections are the following: 1) an information section showing the patient the differences between benign lesions and suspicious or malignant lesions; 2) a section with algorithms to determine the phototype, risk of melanoma, and level of actinic damage; and 3) a dynamic section showing the local UV index and providing practical advice on photoprotective measures and healthy sun exposure.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The main objective of FotoSkin® is to act as a photographic record of the patient's moles and other skin lesions that can later be shown to the dermatologist at checkups (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Visualization of changes in the lesions thus improves the dermatologist's diagnostic accuracy and even improves secondary prevention of the melanoma by enabling the patient to see whether the lesions are new or have changed,<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> as well as encouraging the patient to adhere to self-examination and checkups. The secondary objective of FotoSkin® is to improve health education about melanoma, skin cancer, and healthy sun exposure habits.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The application was designed for smartphones and tablets, both of which have several advantages over a computer,<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> namely, ease of use, rapid photographs and storage, automatic reminders about self-examinations, and, in particular, portability (patients can take their photographs with them when they visit the dermatologist). FotoSkin® is free to download and use and is available for iOS (iPhone, iPad) and for Android.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In conclusion, new technology can help to improve skin self-examination in secondary skin cancer prevention by means of systematized whole-body photographic mapping, reminders, and visits to the dermatologist. It can also help to improve health education and encourage patients to become actively involved in the care and surveillance of their skin.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0035" class="elsevierStylePara elsevierViewall">The FotoSkin® application was funded by ISDIN. However, ISDIN did not participate in the preparation of the content included in the application.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicts of Interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflicts of Interest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Vañó-Galván S. Autocontrol fotográfico mediante <span class="elsevierStyleItalic">smartphones</span> para mejorar el diagnóstico precoz del melanoma. Actas Dermosifiliogr. 2015;106:75–77.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1515 "Ancho" => 1000 "Tamanyo" => 141578 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">General design of the smartphone application FotoSkin<span class="elsevierStyleSup">®</span>.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1894 "Ancho" => 900 "Tamanyo" => 154211 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Patient self-examination screen.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnostic accuracy of patients in performing skin self-examination and the impact of photography" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S.A. 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Ahuja" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2196/jmir.1994" "Revista" => array:5 [ "tituloSerie" => "J Med Internet Res" "fecha" => "2012" "volumen" => "14" "paginaInicial" => "e128" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23017375" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010600000001/v2_201502060417/S1578219014003060/v2_201502060417/en/main.assets" "Apartado" => array:4 [ "identificador" => "6157" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case and Research Letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010600000001/v2_201502060417/S1578219014003060/v2_201502060417/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219014003060?idApp=UINPBA000044" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 9 | 7 | 16 |
| 2024 October | 73 | 40 | 113 |
| 2024 September | 92 | 29 | 121 |
| 2024 August | 114 | 76 | 190 |
| 2024 July | 81 | 27 | 108 |
| 2024 June | 82 | 30 | 112 |
| 2024 May | 75 | 29 | 104 |
| 2024 April | 73 | 22 | 95 |
| 2024 March | 70 | 29 | 99 |
| 2024 February | 79 | 29 | 108 |
| 2024 January | 52 | 32 | 84 |
| 2023 December | 58 | 21 | 79 |
| 2023 November | 62 | 31 | 93 |
| 2023 October | 57 | 36 | 93 |
| 2023 September | 71 | 26 | 97 |
| 2023 August | 40 | 18 | 58 |
| 2023 July | 36 | 36 | 72 |
| 2023 June | 50 | 18 | 68 |
| 2023 May | 51 | 24 | 75 |
| 2023 April | 50 | 25 | 75 |
| 2023 March | 34 | 19 | 53 |
| 2023 February | 37 | 15 | 52 |
| 2023 January | 42 | 23 | 65 |
| 2022 December | 47 | 37 | 84 |
| 2022 November | 26 | 26 | 52 |
| 2022 October | 24 | 13 | 37 |
| 2022 September | 24 | 34 | 58 |
| 2022 August | 23 | 22 | 45 |
| 2022 July | 23 | 112 | 135 |
| 2022 June | 30 | 26 | 56 |
| 2022 May | 39 | 27 | 66 |
| 2022 April | 56 | 42 | 98 |
| 2022 March | 63 | 48 | 111 |
| 2022 February | 38 | 23 | 61 |
| 2022 January | 48 | 27 | 75 |
| 2021 December | 34 | 33 | 67 |
| 2021 November | 38 | 42 | 80 |
| 2021 October | 43 | 43 | 86 |
| 2021 September | 37 | 27 | 64 |
| 2021 August | 35 | 26 | 61 |
| 2021 July | 26 | 26 | 52 |
| 2021 June | 43 | 28 | 71 |
| 2021 May | 35 | 19 | 54 |
| 2021 April | 71 | 39 | 110 |
| 2021 March | 71 | 22 | 93 |
| 2021 February | 32 | 46 | 78 |
| 2021 January | 32 | 16 | 48 |
| 2020 December | 29 | 15 | 44 |
| 2020 November | 19 | 11 | 30 |
| 2020 October | 12 | 7 | 19 |
| 2020 September | 23 | 4 | 27 |
| 2020 August | 24 | 18 | 42 |
| 2020 July | 24 | 5 | 29 |
| 2020 June | 28 | 24 | 52 |
| 2020 May | 24 | 15 | 39 |
| 2020 April | 43 | 17 | 60 |
| 2020 March | 36 | 20 | 56 |
| 2020 February | 2 | 2 | 4 |
| 2020 January | 4 | 4 | 8 |
| 2019 December | 8 | 2 | 10 |
| 2019 November | 6 | 0 | 6 |
| 2019 October | 0 | 1 | 1 |
| 2019 September | 4 | 1 | 5 |
| 2019 August | 4 | 5 | 9 |
| 2019 July | 8 | 2 | 10 |
| 2019 June | 4 | 6 | 10 |
| 2019 May | 7 | 8 | 15 |
| 2019 April | 2 | 7 | 9 |
| 2019 March | 0 | 3 | 3 |
| 2019 February | 4 | 48 | 52 |
| 2019 January | 2 | 0 | 2 |
| 2018 December | 2 | 1 | 3 |
| 2018 November | 3 | 0 | 3 |
| 2018 October | 3 | 0 | 3 |
| 2018 September | 7 | 1 | 8 |
| 2018 August | 0 | 5 | 5 |
| 2018 June | 0 | 1 | 1 |
| 2018 May | 0 | 7 | 7 |
| 2018 April | 0 | 2 | 2 |
| 2018 March | 0 | 2 | 2 |
| 2018 February | 61 | 6 | 67 |
| 2018 January | 52 | 6 | 58 |
| 2017 December | 79 | 6 | 85 |
| 2017 November | 32 | 5 | 37 |
| 2017 October | 32 | 3 | 35 |
| 2017 September | 39 | 6 | 45 |
| 2017 August | 46 | 7 | 53 |
| 2017 July | 42 | 8 | 50 |
| 2017 June | 39 | 23 | 62 |
| 2017 May | 36 | 13 | 49 |
| 2017 April | 47 | 13 | 60 |
| 2017 March | 32 | 13 | 45 |
| 2017 February | 28 | 9 | 37 |
| 2017 January | 99 | 9 | 108 |
| 2016 December | 30 | 17 | 47 |
| 2016 November | 44 | 14 | 58 |
| 2016 October | 36 | 29 | 65 |
| 2016 September | 0 | 6 | 6 |
| 2016 August | 0 | 2 | 2 |
| 2016 July | 10 | 3 | 13 |
| 2016 June | 21 | 1 | 22 |
| 2016 May | 7 | 17 | 24 |
| 2016 April | 10 | 14 | 24 |
| 2016 March | 4 | 1 | 5 |
| 2016 February | 8 | 2 | 10 |
| 2016 January | 9 | 1 | 10 |
| 2015 December | 12 | 2 | 14 |
| 2015 November | 18 | 1 | 19 |
| 2015 October | 8 | 3 | 11 |
| 2015 September | 8 | 6 | 14 |
| 2015 August | 10 | 3 | 13 |
| 2015 July | 28 | 9 | 37 |
| 2015 June | 16 | 4 | 20 |
| 2015 May | 18 | 14 | 32 |
| 2015 April | 15 | 14 | 29 |
| 2015 March | 17 | 4 | 21 |
| 2015 February | 6 | 2 | 8 |
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